June 14, 2001 Research Update

James Bogash, D.C. Mesa, AZ
info@lifecarechiro.com
www.lifecarechiro.com

Antibiotics Losing Their Power Against Acne

Is this any big surprise? Forget acne--how about the long term damage to normal flora when a patient is put on long term broad spectrum antibiotics for a condition such as acne? In my office, if a patient presents to me with severe allergies, almost invariably there has been some long term antibiotic use during childhood--recurrent ear infections, recurrent pneumonia or acne. This repeated, long term use destroys the normal flora that performs such an essential function in the developing immune system. Acne can be addressed from a multifactorial approach quite successfully. This involves avoidance of common allergens (corn, wheat, dairy) and restoration of normal GI function.

Annual meeting of the American Society for Microbiology Growing resistance of Propionibacterium acnes to antibiotics may mean that "the use of antibiotics to treat acne should be restricted and other regimens should be tested," according to Dr. Carl Erik Nord of the Karolinska Institute in Stockholm, Sweden. Dr. Nord presented study findings here at the annual meeting of the American Society for Microbiology. His team analyzed resistance to commonly used antibiotics such as erythromycin and tetracycline in P. acnes cultures obtained from the skin of 99 patients with severe acne, all of whom had been treated with antibiotics for between 2 and 6 months. The researchers compared levels of resistance in those patients with levels in 30 patients with similar diagnoses who had never received antibiotic acne therapy. "What we found was significantly more resistant skin bacteria in the antibiotic-treated patients," Dr. Nord told Reuters Health. Drug-resistant strains of P. acnes were recovered from 28% of patients who had undergone antibiotic therapy and 6% of those who had not.

UK Issues Tougher Warnings on Zyban

I must admit, this is the first I've heard of these warnings with the use of Zyban. This is tough ground to tread on. It's always easy to beat up on pharmaceutical drugs (sometimes too easy!!), but in this case it's difficult. When Zyban is used along with the patch for smoking cessation, the effectiveness just markedly. So, we have a potential short term therapy that effectively helps many smokers quit; lowering the risk of many diseases that smoking contributes to. Dangerous side effects do complicate the issue and patients need to be fully informed. I know there are natural alternatives to smoking cessation, but I am unfamiliar with any in my practice.

(article) Tougher warnings for physicians prescribing GlaxoSmithKline's smoking cessation drug Zyban (bupropion) were announced on Thursday by the UK's Committee on Safety of Medicines (CSM). Bupropion is also marketed under the tradename Wellbutrin as an antidepressive agent. In a statement, the CSM said existing warnings for prescribers relating to risk factors for seizures should be strengthened to emphasise that Zyban should only be used in patients with these factors if there are compelling clinical reasons. The CSM added that the prescribing regime should be amended to delay the increase in dose from day 4 to day 7 of treatment to give more time for drug levels to stabilise. Over 5000 adverse reports have been received for Zyban of which 40 have been associated with a fatal outcome, the statement said. "At least 419,000 patients are estimated to have used Zyban. About 2% of adverse reports for all medicines are associated with a fatal outcome. For Zyban, the proportion of reports that is fatal is much lower — less than 1%. The CSM considers that the reports received are in line with the known safety profile of Zyban." Last month, British coroner Alan Lawson called for improved warnings to ensure patients do not take the drug with certain other medications which can potentiate the effect of Zyban. His comments came as he recorded a verdict of death by natural causes on airline flight attendant Kerry Weston, 21, of Broxbourne, Herts who was found dead in her hotel room in Nairobi a fortnight after she was prescribed Zyban. The court heard she was also taking chloroquine and sleeping pills. Thursday's statement from the CSM says patients who are considering taking Zyban should tell their doctor if they have ever had a convulsion or unexplained blackout. It also makes clear that there are certain medicines and medical conditions that require reducing the dose of Zyban. The statement says patients should tell their doctor or pharmacist about past head injuries, insulin-dependent diabetes, and heavy drinking. Patients should also tell prescribers if they are taking any of the following: anti-malarial medicines (such as chloroquine or proguanil); certain antihistamines, some of which may be used for sleep problems; antidepressive agents or other psychotropic drugs (such as clozapine, risperidone or thioridazine); theophylline; steroids; certain antibiotics (for example, ofloxacin, levofloxacin or norfloxacin); tramadol; slimming medicines or other stimulants.

The Misunderstood Gene

This is a book review that is so appropriate for our times that I had to include it. We are so focused on looking at our genes for the answer to all of human diseases. The author, Michel Morange, takes a very realistic view at what we really have now that the genome project has been completed--no more than we did before! The review is a little long, but definately worth the time.

(review by Fintan R. Steele, PhD in MedGenMed, May 29, 2001) The publishing of the "complete" human genome sequence earlier this year was heralded with the kind of breathless superlatives usually reserved for Chinese restaurant menus: incredible, astounding, awesome, unequaled, and so forth. Not only the media but scientists who should know better proclaimed the "deciphering of the book of life," promising the imminent end to human disease and aging and the final key to the secret of human nature. In The Misunderstood Gene, Michel Morange, Director of the Center for the Study of the History of Science at the Ecole Normale Superieure in Paris, France, and author of A History of Molecular Biology, effectively tempers the extreme enthusiasm with a hard look at how impoverished our genetic "breakthrough" truly is, and even how dangerous a little knowledge can be.In short, Morange argues that all living creatures are more than the sum total of their genes. Granted, this is hardly a novel position for anyone but the most hardened reductionist to hold. But Morange skillfully weaves a picture of the incredibly complex molecular dance of life itself, in which genes are but a fairly small player. Deftly setting aside the popular understanding of genes that drives most press releases and news reports, Morange points out that the current emphasis on genes as opposed to proteins (where he locates the real work), tissues, organs, whole organisms and environments, is more of a reflection of the current state of experimental molecular science, not of the relative importance of genes to biological life. Not surprisingly, the marketplace has already grasped this truth: Witness the precipitous plunge in the value of genome science stocks. But the general public and many scientists have not yet learned, and Morange claims to be writing for them.This book is not a philosophical treatise: Morange describes and discusses specific examples from the current scientific literature of genes implicated in behavior, disease, development, aging, and death. Usually presented in the popular press as definitive studies, "genes for" these things (an incorrect usage, as Morange points out) are, in fact, only teasingly suggestive of some kind of causality. Morange hammers his point home by citing mouse "knockout" studies, ie, mice in which a gene believed to be critical for some function is disabled and the knockout mouse analyzed for defects. In fact, thanks to the genomic redundancy that accompanies -- and probably leads to -- evolutionary complexity, many of these experiments have resulted in scientists desperately slicing their knockout mouse into increasingly smaller pieces to determine any kind of phenotypic change that would justify publication.What, then, are genes, if not the words of the book of life? Morange argues, in a way reminiscent of the Via Negativa of medieval philosophers and mystics discussing God, that there is no universally valid definition of the gene: We now only understand the gene by metaphors, none of which is perfectly correct or entirely complete. Indeed, without knowing the full context in which genes exist and to which they contribute, we can say very little, and should probably do even less. Although there are some obvious therapeutic actions we could consider in what is known as "somatic gene therapy," Morange points to our basic genetic ignorance to sternly warn against germ-line gene therapy, despite the incredible temptation offered by available technology. He also roundly condemns eugenics: not just the straw horse associated with Nazi experimentation, but the "positive" eugenics creeping into our desire to make things better.Morange is not a Luddite, by any means, but he is a realist. This book should be required reading for anyone associated with genomic research or gene therapy, in addition to the general public that Morange claims as his target audience. In solemnly assaying the limits of our knowledge, he also successfully describes the incredible beauty and complexity of biological life. Indeed, Morange gives the reader the sense that "whatever is, is right," but he also makes it very clear that our current limited knowledge cannot yet say with any certainty what truly "is."

Vitamin Supplement Use and Diabetes Mellitus

This study does not identify specific vitamins, but I can guess at some of the specific vitamins present in a multi that could reduce the risk of diabetes. Vanadium and chromium are known to help insulin do it's job. The B vitamins help the liver process glucose. However, I would rather see a patient take multivitamin in conjuction with a healthy lifestyle instead of having them take specific nutrients to lower the risk of specific diseases. Remeber that maintaining a healthy lifestyle lowers your risk of ALL diseases... Am. J. Epidemiol. -- Abstracts: Ford 153 (9): 892 http://www.aje.oupjournals.org/cgi/content/abstract/153/9/892

Pharmacological and endogenous progestins induce vascular endothelial growth factor expression in human breast cancer cells

I left the long title for a reason here. At first glance, this article appears to suggest that progesterone produced by the body may increase breast cancer risk. Reading into the article itself arises some very, very important issues. These are related to nomenclature. Progestins are synthetic hormones that have been altered in order to create a patent on the substance. They mimic progesterone but THEY ARE NOT PROGESTERONE. They have been mutated and the body knows the difference. This article does NOT use progesterone--the authors used progestins and then extrapolated the results over to natural progesterone--a very dangerous and unforgivable error. It would be interesting to see if natural progesterone actually did have the same effects. I believe it would not. Article Abstract http://www3.interscience.wiley.com/cgi-bin/abstract/78002653/START

Increased Need for Thyroxine with Hypothyroidism during HRT

Will the lack of understanding of basic physiology never end? It is known that estrogen blocks the conversion of T4 to T3 (the thyroid produces mainly T4-the inactive form--it needs to be converted to its active form later in the target tissues). So, it is no surprise that estrogen replacement therapy will increase the need for thyroid hormone replacement. Here's a novel idea--instead of giving another drug to make up for the side effects of the first-how about managing menapause naturally and avoiding the need for HRT? Consider the possibilty that nature specifically designed menopause to protect the female body from the accumlated effects of aging? Does HRT then sound like such a good idea? NEJM -- Abstracts: Arafah 344 (23): 1743 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?SUBMIT=y

Inhibitory Effect of a Two Day Fast on Reactive Oxygen Species (ROS)

Fasting is a tool used by many alternative practioners to modify the body's inflammatory response and reduce the body's exposure to irritating elements from outside (food...). This study further confirm's the benefits of this tool in lowering the oxidative stress to an individual undergoing a fast. JCEM -- Abstracts: Dandona et al. 86 (6): 2899 http://jcem.endojournals.org/cgi/content/abstract/86/6/2899